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Am J Crit Care. 2005 Jan;14(1):17-25.

Attitudes of critically ill Filipino patients and their families toward advance directives.

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School of Nursing, The University of California-San Francisco, San Francisco, CA, USA.



Advance directives are important but often underused tools in critical care. Healthcare professionals' understanding of how culture influences attitudes toward advance directives can improve knowledge and completion of these documents.


To understand the attitudes of critically ill Filipino American patients and their families toward advance directives.


A descriptive, correlational, cross-sectional study with a convenience sample of 22 Filipino American patients and 22 Filipino American family members at a West Coast medical center. All patients were admitted for cardiac surgery or cardiac interventions. Participants were interviewed with the Advance Directive Attitude Survey and A Short Acculturation Scale for Filipino Americans.


Family members' scores were significantly more positive than patients' scores on the attitude survey (P = .01). Family members were more American acculturated than were patients (P = .001). Family members with more education had more positive attitudes toward advance directives (P = .02). Only 2 patients (and no family members) had completed an advance directive before the study. Only 27.3% of family members had prior knowledge of advance directives.


Overall attitudes toward advance directives were positive; however, the completion rate and knowledge of advance directives were low. Participants may have been saying what they thought the researcher wanted to hear in order to avoid disagreement. Such behavior could partly explain the positive attitudes of the Filipino Americans toward advance directives. Further research is warranted to understand how to increase completion rates for advance directives among Filipino Americans.

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